Huda M. Hammad

Oral lichen planus shows higher expressions of tumor suppressor gene products of p53 and p21 compared to oral mucositis. An immunohistochemical study

OBJECTIVE Oral lichen planus (OLP) has been speculated to be a chronic inflammatory disease with potential for malignant progression. The aim of this study was to establish a hypothesis on the difference between OLP and oral mucositis (OM) in terms of tumor suppressor gene expression. DESIGN Computer based image analysis of immunohistochemical expressions of p53 and p21 was investigated in 18 samples of OLP, 10 normal oral epithelium (NOE), 10 oral squamous cell carcinoma (OSCC), 13 OM, 20 oral focal keratosis (OFK), and 30 samples of oral epithelial dysplasia (OED). Representative fields were digitized and analyzed. RESULTS Using independent samples Students t-test, p53 and p21 the mean percentages of positive nuclei (MPPN) of p53 (40.27%) and of p21 (39.98%) in OLP were significantly higher than that of NOE, OFK and OM (15.06%, 27.87%, 30.08% and 16%, 31.09%, 33.92% respectively, p<0.001). MPPN of p53 in OLP was not different from that of mild OED (40.5%, p=0.85) but lower than of moderate and severe OED, and OSCC (49.78%, 61.36%, 78.16% respectively; p<0.001). MPPN of p21 in OLP was lower than that of moderate and severe OED, and OSCC (47.72%, 57.9%, 85.44% respectively; p<0.001) but slightly higher than that of mild OED (39.86% p=0.81). CONCLUSIONS As the expression of p53 and p21 in OLP was significantly higher than that of oral mucositis with no significant difference from mild epithelial dysplasia, OLP might need to be followed up and monitored more closely to detect early features of transformation, if any, compared to non-specific oral mucositis which needs no close follow-up.

Chondromyxoid fibroma of the jaws: Case report and review of the literature

Chondromyxoid fibroma is a benign tumor of bone that is characterized by chondroid and myxoid differentiation and by ultrastructural and immunohistochemical evidence of chondral origin. It is rare in the jaws and skull bones, where only about 2% of all cases have been reported. A review of the 20 acceptable gnathic cases in the literature and of the current case revealed both a higher incidence in the mandible (76%) than in the maxilla (24%) and an equal sex distribution. The sites of occurrence in both jaws are compatible with origin from developmental cartilaginous remnants. The controversies regarding malignant transformation and therapeutic approach are addressed.

Orofacial findings in chronic granulomatous disease: report of twelve patients and review of the literature

BackgroundChronic granulomatous disease is an extremely rare primary immunodeficiency syndrome that can be associated with various oral complications. This can affect high number of patients. However, data on oral complications is sparse. Here we will review the literature and describe the orofacial findings in 12 patients.FindingsThe age range was 5-31 years. Oral findings were variable, and reflected a low level of oral hygiene. They included periodontitis, rampant caries, gingivitis, aphthous-like ulcers, and geographic tongue. One patient had white patches on the buccal mucosa similar to lichen planus. Another patient had a nodular dorsum of the tongue associated with fissured and geographic tongue. Biopsies from the latter two lesions revealed chronic non-specific mucositis. Panoramic radiographs showed extensive periodontitis in one patient and periapical lesions in another patient.ConclusionPatients with chronic granulomatous disease may develop oral lesions reflecting susceptibility to infections and inflammation. It is also possible that social and genetic factors may influence the development of this complication. Therefore, oral hygiene must be kept at an optimum level to prevent infections that can be difficult to manage.

Histological evaluation of rat tissue response to GMTA, Retroplast, and Geristore retrograde filling materials

The aim of the study was to compare the short-term biocompatibility of grey mineral trioxide aggregate (GMTA), Retroplast and Geristore. Silicon tubes filled with the materials and empty control tubes were implanted in the dorsal connective tissue of 30 Wistar albino rats. The tubes and surrounding tissues were excised and prepared for histological examination at 1 week, 1 month and 2 months after implantation. Inflammatory cell counts and the presence or absence of necrosis adjacent to the materials and control tubes were recorded. Data were statistically analysed using one-way anova and Tukeys multiple comparisons tests. The empty control tubes were well tolerated. All tested materials showed a more severe initial reaction than the control group. With time, the reaction became chronic, with variable increase in the numbers of inflammatory cells. Retroplast recorded the most statistically significant increase in the sum of inflammatory cells. Although the increase in the sum of inflammatory cells was statistically significant for Geristore but not for GMTA, the inflammatory cell counts for both were comparable. It was concluded that the three materials continued to irritate tissues throughout the evaluation period. Retroplast was the least biocompatible of the three tested materials at 2 months, followed by Geristore then GMTA.

Plunging arteriovenous malformation in the floor of the mouth: a case report

An arteriovenous malformation (AVM) is composed of abnormal communications between arteries and veins without the normal intervening capillary bed. An 11-year-old male presented with a painless, doughy submandibular mass. Surgical excision was performed through an intraoral approach; the mass and the surgical field, did not exhibit any significant intraoperative bleeding typical of vascular lesions. Histopathological examination of the specimen revealed a diagnosis of an AVM, with the presence of organizing thrombi within arteries and veins. These abundant thrombi, previously unreported in the arterial part, may explain the negligible intraoperative bleeding.

Immunohistochemical expression of K6, K8, K16, K17, K19, maspin, syndecan-1 (CD138), α-SMA, and Ki-67 in ameloblastoma and ameloblastic carcinoma: diagnostic and prognostic correlations

OBJECTIVE To identify cutoff values of markers that correlate with the histopathologic diagnosis of ameloblastic carcinoma (AC) and/or the increased recurrence potential of ameloblastoma (AB). STUDY DESIGN Immunohistochemical expression (IHCE) of 9 selected markers were investigated in 18 non-recurrent ameloblastomas (NRABs), 6 recurrent ameloblastomas (RABs), and 5 ACs. RESULTS No significant difference in IHCE of K6, K8, K16, K17, K18, K19, maspin, or syndecan-1 was observed among study groups. α Smooth muscle actin (α-SMA)-positive area in central epithelial cells significantly differentiated between AB and AC (P = .017; t -test). Ki-67 score significantly differentiated between AB and AC (P < .005; t -test) and between AC and RAB (P = .015; ANOVA/post hoc). CONCLUSIONS Ki-67 score of 75 cells/HPF (ROC curve) is a potential indicator of AC. Clinical recurrence of AB may be predicted by α-SMA expression pattern. Syndecan-1 and α-SMA may indicate a higher aggressive potential of AB when expressed in the stroma.

Reaction of rat connective tissue to mineral trioxide aggregate and diaket

BackgroundThe aim of this study was to compare the reaction of rat connective tissue to two root-end filling materials: white Mineral Trioxide Aggregate (WMTA) and Diaket.MethodsEach of the materials was placed in dentine tubes and implanted subcutaneously in the dorsal connective tissue of 21 Wistar albino rats. Tissue biopsies were collected 7, 30, and 60 days after the implantation procedure. The specimens were processed and stained with hematoxylin and eosin and examined microscopically. After determining inflammatory cell numbers in sections from each specimen, inflammatory reaction scores were defined as follows: 0; no or few inflammatory cells (no reaction), 1; less than 25 cells (mild reaction), 2; 25 to 125 cells, (moderate reaction), and 3; 125 or more cells (severe reaction). Statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney tests.ResultsThere were statistically significant differences in the median inflammatory cell numbers throughout the three test periods, with the most severe degree of inflammation observed at the one-week period. Few cases of necrosis were observed with WMTA. Diaket exhibited the most severe degree of inflammation and necrosis. After 30 days, both materials provoked moderate inflammatory reaction. The eight-week period showed the least severe degree of inflammation in all groups.ConclusionsIt was concluded that WMTA exhibits a more favourable tissue response compared with Diaket which induced more severe inflammatory reaction than WMTA and the control.

DFT computational studies, biological and antioxidant activities, and kinetic of thermal decomposition of 1,10-phenanthroline lanthanide complexes

Abstract[Ln (phen)2(NO3)3] complexes were synthesized by interaction of lanthanide nitrate {Ln (NO3)3.xH2O where Ln = Tb, Eu, Sm, Dy, and La} with 1,10-phenanthroline {phen} in ethylacetate. The complexes were characterized by several analytical and spectroscopic techniques. Density functional theory (DFT) calculations were carried out to optimize the geometries of all prepared complexes at the B3LYP/6-31G(d) level of theory. Vibrational frequencies of the complexes theoretically calculated were in good agreement with experimentally determined values. Most of the complexes exhibited high to moderate antibacterial and antifungal activities in vitro against seven different clinical isolates. The complexes were tested for their antioxidant activity toward 1,1-diphenyl-2-picryl-hydrazyl (DPPH) radical. Dy(III) complex showed the highest activity. Thermal degradation of complexes at different heating rates was investigated by thermogravimetric analysis (TGA). The complexes had high thermal stability. The activation energies (Ea) of the degradation were calculated by Kissinger and Flynn-Wall-Ozawa methods.

Lymphangioma circumscriptum of the tongue: A case with marked hemorrhagic component

Lymphangioma circumscriptum (LC) is considered a superficial variant of lymphangioma with characteristic small lymphatic channels. Diagnosis is routinely made through histopathology in addition to immunostaining. An unusual case of LC presenting as a painless overgrowth of the tongue in a middle‐aged male is reported, with emphasis on the clinical and histopathological differential diagnosis.

Odontogenic myxoma with diffuse calcifications: a case report and review of a rare histologic feature

Calcifications have been rarely reported in odontogenic myxoma. We describe here an additional case and review all reported cases. A 45-year-old female patient presented with a gingival swelling around a mobile mandibular left second molar. Radiographic investigation revealed a large multilocular radiolucent lesion of the posterior mandible. Microscopic examination revealed an odontogenic myxoma with numerous newly formed trabeculae of bone or cementum-like material present throughout the specimen, reminiscent of those seen in fibro-osseous lesions of the jaws. After total excision, regular follow-up of the patient showed gradual healing of the surgical defect. To our knowledge, only a few documented cases of odontogenic myxoma with calcifications have been reported in the literature. This histopathologic finding is rare but should not lead to the misdiagnosis of a central odontogenic fibroma, cemento-ossifying fibroma, fibro-osseous lesion, or low-grade osteosarcoma.